Publication of the week: Dr Jasmine Hearn

7 March 2018

Hearn, J H, Selvarajah, S., Kennedy, P., and Taylor, J. (2018) Stigma and self-management: an Interpretative Phenomenological Analysis of the impact of chronic recurrent urinary tract infections after spinal cord injury. Spinal Cord Series and Cases (2017)4(12).

Each year in the UK around 1,200 people are diagnosed with a spinal cord injury (SCI) of which urinary tract infection (UTI) associated with bladder dysfunction is one of the most debilitating secondary complications. The majority of cases with recurrent UTI receive antibiotics as the first line of treatment for both prevention and treatment.

Now, a study initiated by Stoke Mandeville Spinal Research (SMSR), funded by the National Institute of Health Research (NIHR), sponsored by Buckinghamshire Healthcare NHS Trust has shown that those with a SCI who have experienced recurrent UTI are concerned about their over reliance on antibiotics with the fear that they may stop working. This echoes growing concern that resistance to antibiotics poses a major global threat to public health.  Experts from the World Health Organization (WHO) and Public Health England have warned that the issue of antibiotic resistance is reaching a crisis point. The study shows that people with UTIs adopt a trial and error approach to test alternative treatment options such as cranberry tablets and probiotics – even though there is limited evidence for their effectiveness  and could leave them at risk of infection.

The year-long study with participants aged between 28 – 68 years old also found that the stigma and fear of UTI symptoms, such as incontinence, has a significant impact on emotional wellbeing and quality of life. This impacts on social participation, highlighting the need for additional planning by the person with SCI to lead a normal active life, as well as pressure to maintain consistent bladder management routines.

Leading the research as Principal Investigator, Dr. Jasmine Hearn of The University of Buckingham, said: “This study provides real insight into the impact of UTIs on the life of someone who is paralysed, and demonstrates that people are hyperaware of the risks of repeated antibiotic use, and these fears are only bolstered by the lack of alternatives. We also need more psychosocial support for people experiencing recurrent infections.  Specifically, support to help people continue to engage with daily life whilst reducing concerns about other people’s reactions.”

Read more on the publisher’s website.

 

Dr Jasmine Hearn teaches Psychology at The University of Buckingham Medical School, and collaborated with colleagues at Stoke Mandeville Spinal Research on this project (Dr Sen Selvarajah, Dr Paul Kennedy, and Dr Julian Taylor). Stoke Mandeville Spinal Research are now running a large-scale trial studying the effectiveness of a new probiotic in preventing/reducing the recurrence of UTIs after SCI.